New diagnostic tools to screen and assess a still too underestimated disease: the role of the wrist-worn peripheral arterial tonometry device-a systematic review.
Level 1 - systematic review of randomized trials
Systematic review of diagnostic accuracy studies comparing index test against reference standard
PubMed 36036338 · doi:10.1007/s11325-022-02700-4
What was done
A systematic review was conducted to evaluate the diagnostic performance of the wrist-worn peripheral arterial tonometry device (WatchPAT) compared to standard polysomnography (PSG) for obstructive sleep apnea. Investigators identified 18 clinical validation studies encompassing 1,049 patients aged 8 to 70 years (including 74 pediatric patients). Most studies evaluated simultaneous overnight PSG and WatchPAT in a sleep laboratory, while others used a two-night protocol. A qualitative synthesis was performed.
What was found
WatchPAT showed consistent agreement with PSG for apnea-hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), and oxygen saturation (SO2). In studies assessing diagnostic accuracy parameters, sensitivity ranged from 87% to 96% and specificity ranged from 66% to 80%.
Why it matters
Wrist-worn peripheral arterial tonometry offers a practical, highly sensitive alternative to in-laboratory polysomnography for screening and diagnosing sleep-disordered breathing.
Limits
The review performed only a qualitative synthesis without statistical pooling or meta-analysis. Specificity was moderate and variable (66% to 80%), indicating a potential for false positives. Evidence in pediatric populations was limited to only 74 patients across the included studies.
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